Provider Demographics
NPI:1356069983
Name:SIKES, ELIZABETH LUCILLE (PHARMD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LUCILLE
Last Name:SIKES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LUCIE
Other - Middle Name:
Other - Last Name:SIKES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:715 SPAULDING FARM RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:715 SPAULDING FARM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6029
Practice Address - Country:US
Practice Address - Phone:864-349-9095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC43350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist